"The patient is a 30-week pregnant woman, consider the upper respiratory tract infection, there is fever, the temperature is up to 38.4 , now not fever. There is nasal congestion and runny nose." The doctor in the fever clinic reported the history to me.
"And is there anything specific on the obstetric side? Any abdominal pain, vaginal bleeding?"
"That to no, fetal heartbeat and fetal movement are normal. No obstetric symptoms. But it is international practice to ask you to take a look at any big belly!"
So I briefly inquired about the general condition of the pregnant woman again, and indeed there were no obstetric abnormalities, and the fetal heartbeat and fetal movement were normal.
"What about the information for the card?"
"Wooden with ~"
"Recently do ultrasound when to do ultrasound?" It is customary for one's first visit to need to know the basics of her entire pregnancy, including mid-pregnancy screening, late-pregnancy ultrasound, etc.
"It was just done the day before yesterday, but the report was not with me and the doctor said it was normal."
But I wanted to check her checklist myself, so I opened the PACS system, entered the mother's name, xxx, and clicked "Search." The system pops up a box saying "No records were accessed"!
"Didn't you have an ultrasound at our hospital?"
"Yes, I got my card at the Maternal and Child Health Center!"
"Why didn't you go directly to the Maternal and Child Health Center when you built your card there?"
"Shouldn't you come to the People's Hospital when you're sick?"
......
The patient's offhand remark struck a chord in my heart, and I couldn't help but feel enlightened! "Sick to the people's hospital, give birth to a child to go to the maternal and child health center", this is probably the logic of thinking of most of the people. Thinking about my misery all those years, probably because of this reason.
"Do you live far away?"
"Not far, just around the corner, walked here!"
"So how come you didn't get a card at our hospital?"
The patient and family did not answer me. They were probably thinking, "Can the People's Hospital also give birth?"
"You go to the Maternal and Child Health Center to give birth, and you come to the People's Hospital only when you are sick. So what if you get sick while giving birth?"
The man looked at me with some hesitation. Want to say something, but do not know how to say, want to say something.
"In our hospital, there is a cardiology department, a respiratory department, an ICU, and they are all specialized. Pregnant women are just as likely to get sick as ordinary people. And, when pregnant women have a combination of medical and surgical conditions, the condition is often more complex and tricky to deal with, and often requires a multidisciplinary approach."
"Oh, right oh, the people's hospital also has an ICU, and people's hospitals can also build cards to give birth!" The man suddenly dawned a sense of realization.
In fact, there is nothing wrong at all with giving birth to a child to go to a women's and children's health center, but if you take it for granted that giving birth to a child should go to, or can only go to a women's and children's health center, then you are very wrong.
"To give birth to a child, go to a formal medical institution. To deliver a baby, have a regular obstetrician or midwife!" This seems very simple logic, in the Chinese people to form a general **** knowledge, through how much hardship, is everyone can not imagine. Maternal and child health center, and the people's hospital to give birth to a child what is the difference between them, what kind of relationship exists between them, today let's take a peek.
At the beginning of the founding of New China, the average life expectancy of the Chinese people is only 35 years old. The main reason for the low average life expectancy of the Chinese people, on the one hand, is the plague, and on the other hand is the high maternal mortality rate and neonatal mortality rate. Therefore, after the founding of New China, the state has spent a great deal of effort in dealing with the problems of maternal mortality and neonatal mortality.
In the past, those who were able to hire a midwife to take care of their children were considered to be in good condition, and many of them were self-produced, or the elders of the family who had given birth to children helped to take care of them. In many places, some witchcraft and feudal superstitions were also popular. Because of the ideology of male superiority and female inferiority, it is considered that women giving birth is a dirty, shameful thing, and cannot give birth in a clean place or bed, and the midwife uses unsterilized hands to check the descent of the fetus, which often leads to infections. The incidence of perineal lacerations, urinary fistulae and fecal fistulae is very high because of poorly controlled labor because of midwifery practices. There is also an epidemic of using unclean bamboo slips and tiles to cut the umbilical cord, leading to a very high incidence of neonatal infections and neonatal tetanus.
Since ancient times, the Chinese people have known that giving birth to a child is to break through a ghost gate, and if you do, it's a joyous occasion, but if you don't, it's a funeral.
Before 1949, 270,000 women and more than 1 million newborns died every year throughout China. It can be said that the health of women and children is the primary health problem of the people of new China. The planning and development of maternal and child health care came about against this background.
So, in the beginning, there was no maternal and child health center, but the general hospitals have always had obstetrics and gynecology, department of obstetrics and gynecology doctors can not solve the problem of maternal and child health of the general public. The first step in the cause of maternal and child health was the training of midwives. The training of midwives can be traced back to 1928, when the first training course for midwives was organized by doctors from the Peking Union Medical College Hospital.
On October 1, 1949, the new China was founded, and the Ministry of Health of the Central People's Government was established.
In August 1950, the Ministry of Health convened the first National Health Conference with the main task of "oriented to the workers, peasants, and soldiers, with the main task of prevention, and unity between traditional Chinese and Western medicine". Then held the first national symposium on maternal and child health work, established the "promotion of new methods of delivery, reduce infant and child morbidity, the transformation of the old midwife, the training of midwives" and other tasks.
Because the country's demand for midwifery is very large, and the time to train a full range of clinicians is very long, the short-term training to train a large number of staff specializing in midwifery is a very good way to solve this contradiction. At the same time, to ensure the safety of pregnant women and mothers, but also need to be connected to the upper and lower maternal and child health care system, so maternal and child health care centers gradually came into being.
Maternal and child health institutions are health institutions that specialize in solving maternal and child health problems. The earliest maternal and child health care institutions were maternal and child health care stations, or midwifery stations. Many of you may still remember the township "guidance stations", which were in the context of family planning, and were in fact a form of maternal and child health care station.
Before 1949, there were 80 maternal and child health centers with 1,762 beds, 5 children's hospitals with 139 beds, and 9 maternal and child health centers (stations) with no beds. By 1952, the number of maternal and child health-care stations nationwide had increased to 2,379, and the number of midwifery stations had increased to 2,919, as well as 638 midwifery stations. However, this is still far from meeting the needs of the general public.
In 1986, the state planned to increase the number of obstetrics and pediatrics wards by 40,000 each during the "Seventh Five-Year Plan" period. For provinces and cities that did not have obstetrics and gynecology and pediatrics hospitals, corresponding specialized hospitals were set up to facilitate women's births, hospitalizations, and children's medical care. For provinces that did not have provincial-level maternal and child health-care institutions, they were required to utilize all available resources and create all available conditions to establish them as soon as possible. At that time, there were only 300 counties in the country that did not have independent maternal and child health centers.
Many of today's very good maternal and child health centers, such as Sichuan Provincial Maternal and Child Health Center, Henan Provincial Maternal and Child Health Center, and Hebei Provincial Maternal and Child Health Center, were established and gradually developed during that period.
Compared with general hospitals, maternal and child health centers are incomplete in terms of quality of personnel, hardware and software equipment, and comprehensive evaluation of the health care system. However, they are equipped with a full set of preconception health care, pregnancy health care, and delivery and puerperal health care, which is sufficient to cope with the general problems of pregnant women and newborns. And the process-oriented operation system makes its operation extremely efficient.
There is a common perception among the general public that it is better to go to a specialized hospital for any kind of medical treatment. In fact, when the establishment of the maternal and child system, can quickly cater to the thinking of the people, so that the behavioral habits of childbirth from home, from the rural areas to professional institutions, and the people's ideas in this regard is related. Only the people do not realize the complexity of medicine, and that many of the best and most advanced specialties are not found in specialized hospitals, but in general hospitals. A variety of "rare disease, stubborn disease" of private hospitals is to take advantage of this mentality of the people, such as "psoriasis hospital", "epilepsy hospital", "Vitiligo Hospital", "Rheumatism Hospital", "Gout Hospital" ......, I can not say they are not formal! I can't say that they are not formal, but taking such a name is essentially to attract the attention of the people. And this kind of medical institutions, even in their advantageous disease, can do top not many. "The first thing you need to do is to get your hands on a new one, and you'll be able to do it in a way that's easy for you.
The maternal and child health care system is government-led to promote the formation of maternal and child health centers, the establishment of, certainly not to pursue the "gimmick". But because of its name, it did play a positive role in attracting people to standardize their medical care and increase the rate of hospital births. Originally, when the Maternal and Child Health Hospital was established, many of the older obstetricians had changed from nurses to midwives, and then from midwives to obstetricians. It can be said that in the early days, most of the obstetricians and gynecologists in the People's Hospital were the "masters" of the obstetricians in the MCH. However, the maternal and child health care system is part of the national public health system, and its development is driven from the top down. From the point of view of public health management, the obstetrics and gynecology department of the People's Hospital is subject to the supervision of the maternal and child health care system in many aspects. All maternity-related data have to be reported through the MCH system, summarized in the MCH, and finally uploaded to the state. So, from being "apprentices" in the early days, the Maternal and Child Health Centers have now been promoted to the status of "leaders".
However, specialized hospitals have their benefits and general hospitals have their advantages. You don't have to go to a maternity home to have a baby, but a general hospital is fine. And for some critical illnesses, some pregnancy combined with medical and surgical diseases, the advantages of the general hospital is very obvious.
Before engaging in gynecologic oncology, I used to work in the obstetrics and gynecology department of a tertiary general hospital, which at that time was the key specialty of critical care obstetrics in the region. There, I was exposed to a very large number of obstetric comorbidities, such as acute appendicitis in pregnancy, acute pancreatitis in pregnancy, acute cholecystitis in pregnancy, acute fatty liver in pregnancy, chronic granulocytic leukemia in pregnancy or a twin fetus, severe asthma in pregnancy (one induced labor, and one delivery all in our hospital), hypertension in pregnancy complicated by HELLP syndrome, heart disease in pregnancy, pregnancy Comorbid SLE ...... have been there for a long time, and things like gestational diabetes and simple gestational hypertension are not considered serious illnesses. For common obstetric emergencies, such as placenta praevia hemorrhage, in most cases, the difference between a maternal and child health center and a general hospital may not be significant, depending on the availability of blood. But in some cases, general hospitals may have more treatment options, such as interventional embolization, which not all hospitals are equipped to provide.
Maternal and child health centers have an advantage in terms of the smoothness of the entire process from obstetrics documentation to delivery and post-delivery recovery.
If you are looking for an ordinary birth certificate and have no complications, it is recommended that you choose the nearest medical institution for birth certificates, and there is not much difference between the Maternal and Child Healthcare Hospital and the People's Hospital, however, if you have any complications, or if your pregnancy has been found to be in a high-risk situation, such as placenta previa, it is recommended that you go to a general hospital for birth certificates.